Morphine: No Cure for Pain

morphine

Just before 6 a.m., my dad’s voice floats through my dreams, a distant call echoing through a warm, nighttime fog.

“Amanda, I can’t breathe.”

My eyes open and before I hear the second syllable of my name a second time, my feet are on the carpet, running, running, down, down, down toward my father who is standing with his walker at the bottom of the stairs, his oxygen cord a tangle at his feet.

“I’m sorry,” he says,  but I can’t breathe.”

He isn’t gasping. He isn’t blue. But he is upset, confused.

I shepherd him through the darkness toward his saggy, lopsided recliner, a green leather monster that moved into our house a few years ago when mom and dad did.

In the kitchen, a few feet away, I reach for morphine, a tiny square bottle packaged like it’s a precious cologne, Chanel No. 5  for the dying. A high school health teacher warned us so many times about the dangers of morphine that even now, 30 years later, it’s counter-intuitive to give this drug to someone I love.

The morphine is the same pine green of NyQuil and no thicker than water. I insert a syringe thinner than a pencil into the bottle and fill it about 1/4 full, only a few drops, less than an 1/8 of a teaspoon, the prescribed dose dad can take once each hour.

When I turn on the light by dad’s recliner, I’m startled. My father is there, but he seems to have turned into my grandfather, his own father who died in 1990.

Until this moment, dad never resembled my grandfather, a self-righteous, blue-eyed Irishman, red hair gone to frost.

We, my father and I, have always been Schneebergers, taller versions of my German grandmother, with hazel eyes, a dimple in our right cheeks, almost always harder on ourselves than we are on others.

“Dad, I’ve got something that is going to help,” I say, holding the syringe where he can see it.

Until now, I’ve only given dad morphine twice a day — once at breakfast and once before bed. Hospice prescribed the opiate after his esophageal cancer and chemotherapy combined to cause weeks of diarrhea, leaving him so weak he couldn’t stand.

Morphine causes constipation, so the diarrhea ended. And I know it can also slow the respiratory system so dad, whose cancer has spread to his lungs, won’t feel like he’s gasping for air.

Dad tilts back his head and opens his mouth, his gums pink and wet, naked without his dentures. And like a mama bird feeding a hatchling, I insert the syringe and plunge the morphine down his throat.

This change, this sudden morphing from Schneeberger to Garrett unnerves me. So does this increasingly unfamiliar and traumatic family drama.

A room away, my mother sleeps, oblivious to her husband’s struggles. More and more she’s living in her own bizarre  dementialand.

Most days she insists she can’t go to the bathroom without eating cheesecake and smoking cigarettes. Other days she says she can’t stop going to the bathroom unless she eats cheesecake and smokes cigarettes.

The television remote control, for her, might as well be a martian spaceship.

She’s can’t figure it out.

Fifteen minutes after I give dad the morphine, he’s still having a tough time breathing.

I worry this is the first of many such episodes to come. No one from Hospice has yet told me what to do.

Maybe dad is having a panic attack, I wonder.

The day before, when I was taking a shower, my dad sobbed to the aide who visited for an hour to give him a bath. Stacie, who’s helped mom bathe for nearly four years and who took care of my aunt with Alzheimer’s before that, is part of our family now and dad trusts her.

He’s been unwaveringly brave in front of me, but he confided his deepest fear to Stacie — suffocation — and she wisely passed that on to me.

I go back to the kitchen and reach for dad’s other new prescription — a generic form of the anti-anxiety drug Xanax.

For a moment, I think about popping one of the tiny yellow pills myself, but I have never taken anything like that and decide it’s too big of a risk. If I have some sort of weird reaction, my husband is saddled with this mess.

So I half-fill a glass — well, really a plastic tumbler with textured sides that old, feeble hands can easily grip — with water and carry the Xanax in to dad. He swallows it, thanks me and closes his eyes.

Eleven days before, dad entered Hospice, both the program and the facility. It happened on a Saturday after he wouldn’t get out of bed.

A nurse practitioner who had visited the day before as part of dad’s palliative care had noticed the decline in his health. She said it was best for him to decide whether he wanted to give up on chemo and opt for Hospice. But she changed her mind on that Saturday when I called and told her about the situation.

A Hospice intake nurse came to our house and, by then, dad was sitting in his recliner. I was ready, as his power of attorney, to  sign the Hospice forms. But dad rallied enough to do make this decision himself and, for this, I will be forever grateful.

Although Hospice would almost certainly argue otherwise, signing up for comfort care is surrendering to your disease. I didn’t want to wave the white flag for dad. It was good for him and for me that he made that choice.

My husband drove dad a mile away to the Hospice care center, a nearly new facility with several indoor fireplaces and rooms that overlook an equally new park where people jog with dogs and push strollers around a blacktop path.

I followed in a separate car with my mother, her wheelchair, three one-gallon Ziplock bags of dad’s medication, dad’s living will, my power of attorney and a pack of dad’s Pall Mall cigarettes, a red Bic lighter stuffed inside.

Three days later, after Hospice got his diarrhea under control, dad came back to our house to celebrate his 58th wedding anniversary with my mom and told me he never wanted to go back to Hospice.

I worry now, watching him in his recliner, that he will end up back in Hospice, that I might not be able to handle this.

It’s been almost an hour since he woke me and I give him another dose of morphine.

This squirt of green, in combination with the Xanax, works.

He nods off.

Later, when I call Hospice, a nurse named Ginger reassures me I did the right thing with the morphine and the Xanax.

She gets permission from a doctor to double dad’s morphine and his Trazadone, a pill he takes before bed that helps the mind relax.

Then she ask me if I know what do when someone dies.

My first thought is “run,” but I don’t say it. I don’t say anything.

Ginger fills the silence with a “What To Do When Someone Dies — For Dummies” talk.

The person will stop breathing. Their eyes may be closed or may still be open.

Don’t panic. Don’t call 9-1-1. Go slow. Take your time. Call Hospice immediately or whenever you’re ready.

Once Hospice arrives, staff will verify the person’s dead. And then, whenever you’re ready — remember, there’s no rush — Hospice will call the funeral home.

As she’s explaining this, my mother hollers from somewhere in the house demanding a cigarette. I seek refuge in the pantry overlooking our wooded backyard and notice for the first time that spring green has started coloring the tips of the trees.

Once Hospice calls the funeral home, Ginger tells me, it usually takes about an hour for the staff to arrive.

The only decision to make then, she says, is whether you want the dead person’s face covered or uncovered as he’s taken from the home.

Who cares, covered or uncovered, I think to myself. Ginger’s already told me my dad’s going to by lying there for hours in my house dead, his eyes possibly open.

By the time I hang up the phone, my husband has taken my mother out for a cigarette and helped my father back to bed.

I reach for the tiny bottle of morphine again to soothe my father’s breathing and wish that Hospice offered something just as powerful to cure my pain.

This happened two days ago. My father is sleeping more, eating less and, for the first time since he was in the Army during the Korean War, passing up cigarettes. Although I  know his final chapter is closing, no one knows when that will be. For now, I stand guard with the morphine and Xanax, trying to make him comfortable. Morphine was one of my favorite bands of the 1990s and a half-dozen of their songs still occupy my favorites list, including “Cure for Pain.”morphine